[rubyfan]

I’m curious what sort of stresses are thought to cause adrenal issues. Can they be environmental/situational vs. chronic hereditary?

About 5 years ago I was fairly healthy, eating great and CrossFit 6 days a week. Then my body started to become tired all the time. I had pretty high work stress at the time along with what might be considered frequent physically stressful workouts. I suddenly found myself sleeping most of my Saturday and Sundays. Struggling during the week, just enough energy to get myself to work and back to crash at night. Eventually dropping exercise altogether. Along the way I started feeling weak, shaky and would have almost tremors in my body. I had read about adrenal stress at the time and suspected it might be an issue.

It’s hard to tell what’s related but I eventually developed prostatitis, a few rounds of cipro and no help. Then almost a year later some pretty severe digestive issues developed and they thought I had Crohn’s disease, then hospitalized due to reaction to medicine. Then kidney stones, gallstones, gallbladder removed. The last few years have been hard but so many people have it worse.

After the gallbladder removal I’ve finally starting to feel meaningfully better, digestive significantly better and prostatitis issues resolved.

I don’t work out like I used to, I’ve had times that I try to get into a running regime but eventually I start to feel sick and pain around my kidneys. I’m able to do extended hours of yard work and be outside for long hours. I’m lucky that my health appears to be coming back. I have no idea the ultimate root cause of all this but I’m counting my blessings.

When I read about stories like this, it’s inspiring and relatable. When doctors and specialists can’t figure it out they send you to someone else or suggest psychiatric issues. It’s disheartening and easy to lose faith in the medical system.

[uberduber]

I'm chronically ill and had bad fatigue. I am a small, skinny woman with no muscle.

So, first time a doctor asked me if I did CrossFit, I thought it was a bit odd but didn't think too much about it. The third time a doctor asked "Do you do CrossFit?" I replied "Does it look like I do CrossFit?!" and she was like "Yeah, it does."

Apparently it's not uncommon where I live that there is some sort of vegan CrossFit disease, where the 80% of the treatment is is to stop being vegan and stop doing CrossFit.

[rubyfan]

Interesting, I was vegan for about a year before starting CrossFit. Was gluten free, alcohol free, dairy free and exercised frequently and felt basically the best of my life. After starting into CrossFit I added meat back into my diet which basically became paleo at that point. After about 10 months the fatigue started.

[throw97]

Vitamin B12 deficiency?

[magic_beans]

A year ago I was doing CrossFit 6 days a week. Then I started getting more and more tired. I developed ulcerative colitis and now I alternate between insomnia and sleeping 12 hours a day.

I think years of physical stress from crossfit triggered latent disease. I'm still trying to get my body working normally again.

Yoga and CBD are helping.

[m348e912]

This is just a shot in the dark but check your vitamin d levels. I am just getting backup the level of activity that I was at after going through a similar situation where I went from running 20+ miles a week to not being able to walk a half mile. 3+ months of vitamin D for me started to move the needle in the right direction.

[rubyfan]

How did you go about testing and treating? Is this a thing a regular doctor can have tested? I have friends that swear by naturopaths and they usually say they start with lots of tests for vitamin levels.

[redis_mlc]

> I was doing CrossFit 6 days a week.

Your muscles (and blood) rebuild on rest days.

So vigorous daily Crossfit would kill you. (see rhabdo)

Nobody, for example, runs a daily marathon, or even half-marathon.

Also, if you're OC enough to do that, you prolly have other issues too.

[rubyfan]

I’ve recently started a regime of CBD and have wondered if it’s helped my health. Of course, it could be placebo and totally unrelated.

[PragmaticPulp]

> I’m curious what sort of stresses are thought to cause adrenal issues. Can they be environmental/situational vs. chronic hereditary?

“Adrenal fatigue” is an alternative medicine diagnosis. It’s a seductively simple narrative for people seeking answers to unexplained medical issues, but the theory is very much pseudoscience instead of actual science.

The biggest red flag for the adrenal fatigue theory is the claim that current blood tests are not sensitive enough to detect it. This is a common trick used by alt-medicine practitioners to dodge contrary evidence. We have medical tests to diagnose genuine adrenal insufficiency (Addison’s disease), but it’s an extremely rare disorder. Statistically speaking, you almost certainly do not have adrenal insufficiency.

The truth is that your adrenal glands are part of a larger system of feedback loops in your body. The adrenal glands don’t operate independently as the adrenal fatigue theorists would suggest, but rather they work in concert with your brain’s hypothalamus and pituitary in a feedback loop known as the HPA axis. Wikipedia can shed more light on the details of HPA axis functionality, but the key point is that the adrenal glands depend on inputs from your brain. That brings me to my main point:

> When doctors and specialists can’t figure it out they send you to someone else or suggest psychiatric issues.

Psychiatric issues can and frequently do manifest primarily as physical symptoms: Lack of energy, low stress tolerance, digestive issues, oversleeping or insomnia. These are hallmark symptoms of depressive disorders.

The fact that your symptoms started around the time of high stress at work combined with frequent, intense exercise is probably not a coincidence. It’s extremely common for people to notice the physical symptoms first and assume that their problem must be located outside of the brain. Your resistance to any psychiatric diagnosis is an extremely common response. Frequently, patients are offended by any suggestion that the origin of their problems is “all in their head” because it feels like a dismissal of their genuine physical symptoms.

However, the key thing to remember is that your brain and your body are not separate systems. They’re one in the same. It took me a long time to realize that drawing a line between mind and body is an artificial boundary that isn’t a helpful distinction when your problems almost certainly overlap both systems.

I think “adrenal fatigue” has become a popular alternative medicine diagnosis precisely because the adrenal glands are located outside of the brain. As I mentioned above, the adrenal glands take inputs from core brain structures. Your adrenals will only produce what the brain tells them to produce. Yet, no one wants to admit that their brain is right place to solve these issues, so they over-focus on the one part of the system that lies outside of the brain. Psychiatry and modern medicine has understood for decades that HPA axis abnormalities are intimately linked to depressive disorders, and that successful depression treatment in any form (therapy, medication, combination) normalizes HPA axis function. At this point, the hardest part is convincing patients to accept psychiatric treatment and give it appropriate time to work.

I’m glad to hear you’re feeling better, but I would encourage you to give your doctors a chance when they suggest psychiatric issues. You’re basically a textbook case of stress-related depressive symptomology. Modern psychiatry may not be perfect, but it’s better than years of unaddressed fatigue and suffering.

[wavepruner]

I've spent the last 15 years convincing my doctors, friends, and family that my physical symptoms are not just a manifestation from mental illness. It took me pushing myself to the point where I could no longer stand up. My legs felt like they were being ripped to pieces when I put weight on them.

I had attempted all the psychiatric treatments recommended to me. None of them ameliorated the physical symptoms.

Then I discovered what physical compounds my body was missing, and the physical symptoms AND mental symptoms resolved. So yes, the mind and body are not separate. They are constructed out of the exact same basic building blocks.

[cpncrunch]

You should look at functional movement disorder, and catatonic depression. I'm not making any comment on your own situation, only on your comment that pushing yourself to the point where you couldn't stand up proves it wasn't psychiatric.

Typically people with ME/CFS/FMD get worse if they push themselves. The key to recovery is rest first and foremost. The symptoms of FMD seem to be a protection mechanism by the brain, and pushing through the symptoms just make it worse.

[wavepruner]

I won't. You don't know what you're talking about unless you have this illness and have a minimum of PhD level of understanding of biochemistry and enzymology.

I've cured myself. Who have you cured? No one I'm sure.

[cpncrunch]

Yes I have had it, and am fully recovered now thanks.

[wavepruner]

Then perhaps we are talking about two separate illnesses.

[wavepruner]

But yes, pain is how your brain protects your body. Pain means you need to rest before your tissues literally rip to pieces from a structural failure.

[cpncrunch]

No, pain isnt always due to structural or physical damage. That is what functional pain is. In many ways it is much worse than physical pain.

[wavepruner]

I do not think this hypothesis is correct. What evolutionary purpose would functional pain serve?

To me, it seems it's a theory to compensate for medical imaging technology that has far too low resolution. Doctors hate admitting that they don't know what's wrong, so instead they claim that the patient is crazy in politically correct terminology with an excessive number of syllables.

Structural tissue damage starts at a molecular level that cannot be seen by medical imaging technology. The fascia alone is too thin to be imaged at all, and so is completely ignored.

Biochemists have delineated in explicit detail how tissue breaks down at the molecular level. And they can reverse it. We need to start listening to them more.

[rubyfan]

Thanks for the perspective. As you said, it’s very tough in the moment to hear from the doctor that it’s in your head. When you’re physically ill and looking for real answers it really feels like a non-answer. To me as a patient that answer feels more like pseudoscience. It might be right or it might not be in my specific case, but when a doctor quickly gives up trying to diagnose a problem and suggests it’s in your head it’s an extremely invalidating experience.

[cpncrunch]

Just to add to the above: the reason that "adrenal fatigue" was coined is because stress does affect the adrenal glands: initially it causes increased release of cortisol and an increase in size in the glands, but chronic stress can result in hypofunction of the HPA axis, resulting in lower cortisol and sometimes shrinking of the adrenal glands. Whether chronic stress results in fatigue and low cortisol depends on the nature of the stressor, the time since onset, personality factors, etc.

http://dx.doi.org/10.1037/0033-2909.133.1.25

Unfortunately the "adrenal fatigue" crowd have taken this little bit of science and completely mangled it, blaming the adrenal glands themselves and pushing dubious supplements that have no scientific basis.

[BirdieNZ]

Just thought I'd add that I was diagnosed with adrenal fatigue by a medical doctor. I was pretty annoyed, after researching it, because it seemed entirely pseudo-scientific.

In reality I had stress-induced depression with a high degree of physical fatigue as one of the symptoms. When I stopped being depressed, my fatigue went away. Adrenal fatigue is nonsense.

[fortran77]

And the "Adrenal Fatigue" alternative medicine folks simply make it harder for a person with an actual adrenal disorder to be diagnosed by a doctor because they are understandably skeptical if a person comes in with a set of vague symptoms and suggests it's related to adrenaline.